array:24 [
  "pii" => "S2173511509701034"
  "issn" => "21735115"
  "doi" => "10.1016/S2173-5115(09)70103-4"
  "estado" => "S300"
  "fechaPublicacion" => "2009-03-01"
  "aid" => "70103"
  "copyright" => "Sociedade Portuguesa de Pneumologia"
  "copyrightAnyo" => "2009"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2009;15:165-78"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3172
    "formatos" => array:3 [
      "EPUB" => 267
      "HTML" => 1931
      "PDF" => 974
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173511509701046"
    "issn" => "21735115"
    "doi" => "10.1016/S2173-5115(09)70104-6"
    "estado" => "S300"
    "fechaPublicacion" => "2009-03-01"
    "aid" => "70104"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2009;15:179-97"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2456
      "formatos" => array:3 [
        "EPUB" => 241
        "HTML" => 1333
        "PDF" => 882
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Four years’ follow up at a smoking cessation clinic"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "179"
          "paginaFinal" => "197"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Casuística de quatro anos de uma consulta de apoio ao fumador"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M. Aguiar, F. Todo-Bom, M. Felizardo, R. Macedo, F. Caeiro, R. Sotto-Mayor, A. Bugalho de Almeida"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "M."
              "apellidos" => "Aguiar"
            ]
            1 => array:2 [
              "nombre" => "F."
              "apellidos" => "Todo-Bom"
            ]
            2 => array:2 [
              "nombre" => "M."
              "apellidos" => "Felizardo"
            ]
            3 => array:2 [
              "nombre" => "R."
              "apellidos" => "Macedo"
            ]
            4 => array:2 [
              "nombre" => "F."
              "apellidos" => "Caeiro"
            ]
            5 => array:2 [
              "nombre" => "R."
              "apellidos" => "Sotto-Mayor"
            ]
            6 => array:2 [
              "nombre" => "A."
              "apellidos" => "Bugalho de Almeida"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509701046?idApp=UINPBA00004E"
    "url" => "/21735115/0000001500000002/v1_201305151507/S2173511509701046/v1_201305151507/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173511509701022"
    "issn" => "21735115"
    "doi" => "10.1016/S2173-5115(09)70102-2"
    "estado" => "S300"
    "fechaPublicacion" => "2009-03-01"
    "aid" => "70102"
    "copyright" => "Sociedade Portuguesa de Pneumologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2009;15:151-64"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3002
      "formatos" => array:3 [
        "EPUB" => 231
        "HTML" => 1761
        "PDF" => 1010
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Endoluminal high dose rate brachytherapy in the treatment of primary and recurrent bronchogenic tree malignancies"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "151"
          "paginaFinal" => "164"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Braquiterapia endoluminal HDR no tratamento de tumores primários ou recidivas na árvore traqueobrônquica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Maria Fortunato, Salvato Feijó, Telma Almeida, Vera Mendonça, Margarida Aguiar, Marília Jorge, Isabel Monteiro Grillo"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Maria"
              "apellidos" => "Fortunato"
            ]
            1 => array:2 [
              "nombre" => "Salvato"
              "apellidos" => "Feijó"
            ]
            2 => array:2 [
              "nombre" => "Telma"
              "apellidos" => "Almeida"
            ]
            3 => array:2 [
              "nombre" => "Vera"
              "apellidos" => "Mendonça"
            ]
            4 => array:2 [
              "nombre" => "Margarida"
              "apellidos" => "Aguiar"
            ]
            5 => array:2 [
              "nombre" => "Marília"
              "apellidos" => "Jorge"
            ]
            6 => array:2 [
              "nombre" => "Isabel Monteiro"
              "apellidos" => "Grillo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509701022?idApp=UINPBA00004E"
    "url" => "/21735115/0000001500000002/v1_201305151507/S2173511509701022/v1_201305151507/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Lung abscesses: Review of 60 cases"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "165"
        "paginaFinal" => "178"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Luísa Magalhães, Diana Valadares, Júlio R. Oliveira, Ernestina Reis"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "Luísa"
            "apellidos" => "Magalhães"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Diana"
            "apellidos" => "Valadares"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#250;lio R&#46;"
            "apellidos" => "Oliveira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Ernestina"
            "apellidos" => "Reis"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Interna Complementar de Medicina Interna &#47; Resident&#44; Internal Medicine"
            "etiqueta" => "<span class="elsevierStyleSup">1</span>"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Assistente Hospitalar de Medicina Interna &#47; Internal Medicine Consultant"
            "etiqueta" => "<span class="elsevierStyleSup">2</span>"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Hospital Geral de Santo Ant&#243;nio&#46; Servi&#231;o de Medicina 1 &#40;Director de Servi&#231;o&#58; Dr&#46; Nelson Rocha&#41; &#8211; Unidade D &#40;respons&#225;vel de unidade&#58; Dra&#46; Ernestina Reis&#41; &#47; Work carried out at Hospital Geral de Santo Ant&#243;nio&#46; Servi&#231;o de Medicina 1 &#40;Department Head&#58; Dr&#46; Nelson Rocha&#41; &#8211; Unidade D &#40;Head&#58; Dr&#46; Ernestina Reis&#41;"
            "etiqueta" => "<span class="elsevierStyleSup">3</span>"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondence to&#47;Correspond&#234;ncia&#58; Hospital Geral de Santo Ant&#243;nio &#8211; Servi&#231;o de Medicina 1&#44; Unidade D&#44; Largo do Prof&#46; Abel Salazar&#44; 4099-001&#44; Porto&#44; Portugal&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Abcessos pulmonares&#58; Revis&#227;o de 60 casos"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2007-11-16"
    "fechaAceptado" => "2008-10-13"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key-words"
          "identificador" => "xpalclavsec159969"
          "palabras" => array:3 [
            0 => "Lung abscess"
            1 => "necrotising pneumonia"
            2 => "lung infections"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec159970"
          "palabras" => array:3 [
            0 => "Abcesso pulmonar"
            1 => "pneumonia necrotizante"
            2 => "infec&#231;&#245;es pulmonares"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Lung abscesses &#40;LA&#41; carry with them severe clinical and social implications&#46; The authors retrospectively analyse case files from a tertiary hospital&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Admissions from 2000 to 2005 codified as LA were identified&#46; Forty-five patients were males and the mean age was 56&#46;2 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;1&#41; years&#46; The average duration of symptoms pre-hospitalisation was 23&#46;0 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>50&#46;2&#41; days&#44; with acute respiratory infection the initial syndrome in 36 patients&#46; Clinical data show LA could have been suspected in 40 patients&#46; Diagnosis was established 8&#46;7 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;4&#41; days after admission&#46; A microbial pathogen was recovered in 26 cases&#46; Primary LA was diagnosed in 27 patients&#46; Dental disease and immunodeficiency were the main risk factors&#46; Other co-morbidities were present in 34 patients&#46; After LA diagnosis&#44; intravenous &#40;IV&#41; antibiotic &#40;AB&#41; was prescribed for 16&#46;5 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;9&#41; days with mean total AB time 39&#46;2 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;7&#41; days&#46; Ten options of AB were used and 23 patients had their initial IV AB changed to a second choice&#46; Six patients needed surgery&#46; Apyrexia was achieved after 6&#46;4 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;4&#41; days of treatment&#46; 21 patients had complications and 7 died&#46; The mean length of hospital admission was 27&#46;5 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;3&#41; days and 38 patients were called for a follow-up visit&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">These data are generally in accordance with the literature&#46; The high male percentage agrees with the similarly high prevalence of alcoholism and lung neoplasms in males&#46; Key facts to ameliorate in order to improve prognosis and length of hospital admission could be a swifter diagnosis and consensus on the AB treatment&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Abcessos pulmonares &#40;AP&#41; acarretam graves implica&#231;&#245;es cl&#237;nicas e sociais&#46; Os autores analisam retrospectivamente a casu&#237;stica dum hospital terci&#225;rio&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Identificaram-se 60 internamentos por AP ocorridos entre 2000 e 2005&#46; Quarenta e cinco doentes eram homens&#59; a idade m&#233;dia foi 56&#44;2 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;1&#41; anos&#46; A dura&#231;&#227;o m&#233;dia dos sintomas de pr&#233;-hospitaliza&#231;&#227;o foi de 23&#44;0 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>50&#44;2&#41; dias&#44; mas a infec&#231;&#227;o respirat&#243;ria aguda foi o modo de apresenta&#231;&#227;o em 36 doentes&#46; Em 40 casos&#44; com base em dados cl&#237;nicos&#44; a suspeita de AP seria elevada&#46; O diagn&#243;stico estabeleceu-se em 8&#44;7 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;4&#41; dias ap&#243;s a admiss&#227;o&#46; Identificou-se agente microbiano em 26 casos&#46; Em 27 doentes classificou-se o AP como prim&#225;rio&#46; Mau estado dent&#225;rio e imunodefici&#234;ncia foram os principais factores de risco&#46; Exis- tiam co morbilidades em 34 casos&#46; Ap&#243;s o diagn&#243;stico&#44; todos receberam antibioterapia &#40;AB&#41; intravenosa &#40;IV&#41; em m&#233;dia durante 16&#44;5 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;9&#41; dias&#46; A m&#233;dia do tempo global de AB foi de 39&#44;2 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;7&#41; dias&#46; Dez op&#231;&#245;es de AB foram usadas e a AB IV inicial alterada em 23 casos&#46; Foi necess&#225;ria cirurgia em 6 doentes&#46; Conseguiu--se apirexia em m&#233;dia ap&#243;s 6&#44;4 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;4&#41; dias&#46; Ocorreram complica&#231;&#245;es em 21 doentes&#59; 7 faleceram&#46; A dura&#231;&#227;o m&#233;dia do internamento foi de 27&#44;5 &#40;&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;3&#41; dias e 38 doentes foram convocados para consulta p&#243;s-alta&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estes dados s&#227;o&#44; em geral&#44; concordantes com a literatura&#46; A elevada percentagem de doentes do sexo masculino coincide com maior preval&#234;ncia do alcoolismo e do carcinoma pulmonar nos homens&#46; Aspectos pertinentes no sentido de melhorar o progn&#243;stico e tempo de internamento poder&#227;o ser a brevidade no diagn&#243;stico e o consenso no tratamento antibi&#243;tico&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Nota&#58; Trabalho apresentado como comunica&#231;&#227;o oral no 13&#46;&#176; Congresso Nacional de Medicina Interna &#8211; 6th European Federation of Internal Medicine Congress&#44; Lisboa&#44; Maio de 2007 &#47; Note&#58; This work was presented as an oral communication at the 13th National Congress of Internal Medicine &#8211; 6th European Federation of Internal Medicine Congress&#44; Lisbon&#44; May 2007&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography&#47;Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:12 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung abscess&#58; diagnosis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;A&#46; Cassiere"
                            1 => "A&#46;M&#46; Fein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Medscape General Medicine"
                        "fecha" => "1999"
                        "volumen" => "1"
                        "numero" => "1"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic lung sepsis&#58; lung abscess&#44; bronchiectasis and empyema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;G&#46; Mansharamani"
                            1 => "H&#46; Koziel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Curr Opin Pulm Med"
                        "fecha" => "2003"
                        "volumen" => "9"
                        "numero" => "3"
                        "paginaInicial" => "181"
                        "paginaFinal" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12682562"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aspiration pneumonitis and aspiration pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;E&#46; Marik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM200103013440908"
                      "Revista" => array:7 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2001"
                        "volumen" => "344"
                        "numero" => "9"
                        "paginaInicial" => "665"
                        "paginaFinal" => "671"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11228282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aspiration diseases&#58; findings&#44; pitfalls and differential diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Franquet"
                            1 => "A&#46; Gim&#233;nez"
                            2 => "N&#46; Ros&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "RG"
                        "fecha" => "2000"
                        "volumen" => "20"
                        "numero" => "3"
                        "paginaInicial" => "673"
                        "paginaFinal" => "685"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The triple threat of aspiration pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;G&#46; Bartlett"
                            1 => "S&#46;L&#46; Gorbach"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1975"
                        "volumen" => "68"
                        "paginaInicial" => "560"
                        "paginaFinal" => "566"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1175415"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changing bacteriology of adult community-acquired lung abscess in Taiwan&#58; <span class="elsevierStyleItalic">Klebsiella pneumoniae</span> versus anaerobes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Wang"
                            1 => "K&#46;Y&#46; Chen"
                            2 => "C&#46;T&#46; Fang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/428574"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2005"
                        "volumen" => "40"
                        "paginaInicial" => "915"
                        "paginaFinal" => "922"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15824979"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of anaerobic bacteria in lung abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;G&#46; Bartlet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/428586"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2005"
                        "volumen" => "40"
                        "paginaInicial" => "923"
                        "paginaFinal" => "925"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15824980"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung abscess revisited&#46; A survey of 184 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;L&#46; Hang"
                            1 => "J&#46;D&#46; Hardy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "1983"
                        "volumen" => "197"
                        "numero" => "6"
                        "paginaInicial" => "755"
                        "paginaFinal" => "761"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6859981"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung abscess&#58; analysis of 252 consecutive cases diagnosed between 1968 and 2004"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Moreira"
                            1 => "J&#46;J&#46;P&#46; Camargo"
                            2 => "J&#46;C&#46; Felicetti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Bras Pneumol"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "numero" => "2"
                        "paginaInicial" => "136"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17273583"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fiberoptic bronchoscopy in the evaluation of lung abscesses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Sosenko"
                            1 => "J&#46; Glassroth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1985"
                        "volumen" => "87"
                        "paginaInicial" => "489"
                        "paginaFinal" => "494"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3979136"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The pathology of Legionella pneumonias&#46; A review of 74 cases and the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;C&#46; Winn Jr&#46;"
                            1 => "R&#46;L&#46; Myerowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Hum Pathol"
                        "fecha" => "1981"
                        "volumen" => "12"
                        "numero" => "5"
                        "paginaInicial" => "401"
                        "paginaFinal" => "422"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6166529"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors predicting mortality of patients with lung abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46; Hirshberg"
                            1 => "M&#46; Sklair-Levi"
                            2 => "R&#46; Nir-Paz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1999"
                        "volumen" => "115"
                        "paginaInicial" => "746"
                        "paginaFinal" => "750"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10084487"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735115/0000001500000002/v1_201305151507/S2173511509701034/v1_201305151507/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9552"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Article&#47;Artigo Original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735115/0000001500000002/v1_201305151507/S2173511509701034/v1_201305151507/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511509701034?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 15. Issue 2.
Pages 165-178 (March - April 2009)
Share
Share
Download PDF
More article options
Vol. 15. Issue 2.
Pages 165-178 (March - April 2009)
Full text access
Lung abscesses: Review of 60 cases
Abcessos pulmonares: Revisão de 60 casos
Visits
955
Luísa Magalhães1,
, Diana Valadares1, Júlio R. Oliveira2, Ernestina Reis2,3
1 Interna Complementar de Medicina Interna / Resident, Internal Medicine
2 Assistente Hospitalar de Medicina Interna / Internal Medicine Consultant
3 Hospital Geral de Santo António. Serviço de Medicina 1 (Director de Serviço: Dr. Nelson Rocha) – Unidade D (responsável de unidade: Dra. Ernestina Reis) / Work carried out at Hospital Geral de Santo António. Serviço de Medicina 1 (Department Head: Dr. Nelson Rocha) – Unidade D (Head: Dr. Ernestina Reis)
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract

Lung abscesses (LA) carry with them severe clinical and social implications. The authors retrospectively analyse case files from a tertiary hospital.

Admissions from 2000 to 2005 codified as LA were identified. Forty-five patients were males and the mean age was 56.2 (±15.1) years. The average duration of symptoms pre-hospitalisation was 23.0 (±50.2) days, with acute respiratory infection the initial syndrome in 36 patients. Clinical data show LA could have been suspected in 40 patients. Diagnosis was established 8.7 (±11.4) days after admission. A microbial pathogen was recovered in 26 cases. Primary LA was diagnosed in 27 patients. Dental disease and immunodeficiency were the main risk factors. Other co-morbidities were present in 34 patients. After LA diagnosis, intravenous (IV) antibiotic (AB) was prescribed for 16.5 (±10.9) days with mean total AB time 39.2 (±15.7) days. Ten options of AB were used and 23 patients had their initial IV AB changed to a second choice. Six patients needed surgery. Apyrexia was achieved after 6.4 (±6.4) days of treatment. 21 patients had complications and 7 died. The mean length of hospital admission was 27.5 (±16.3) days and 38 patients were called for a follow-up visit.

These data are generally in accordance with the literature. The high male percentage agrees with the similarly high prevalence of alcoholism and lung neoplasms in males. Key facts to ameliorate in order to improve prognosis and length of hospital admission could be a swifter diagnosis and consensus on the AB treatment.

Key-words:
Lung abscess
necrotising pneumonia
lung infections
Resumo

Abcessos pulmonares (AP) acarretam graves implicações clínicas e sociais. Os autores analisam retrospectivamente a casuística dum hospital terciário.

Identificaram-se 60 internamentos por AP ocorridos entre 2000 e 2005. Quarenta e cinco doentes eram homens; a idade média foi 56,2 (±15,1) anos. A duração média dos sintomas de pré-hospitalização foi de 23,0 (±50,2) dias, mas a infecção respiratória aguda foi o modo de apresentação em 36 doentes. Em 40 casos, com base em dados clínicos, a suspeita de AP seria elevada. O diagnóstico estabeleceu-se em 8,7 (±11,4) dias após a admissão. Identificou-se agente microbiano em 26 casos. Em 27 doentes classificou-se o AP como primário. Mau estado dentário e imunodeficiência foram os principais factores de risco. Exis- tiam co morbilidades em 34 casos. Após o diagnóstico, todos receberam antibioterapia (AB) intravenosa (IV) em média durante 16,5 (±10,9) dias. A média do tempo global de AB foi de 39,2 (±15,7) dias. Dez opções de AB foram usadas e a AB IV inicial alterada em 23 casos. Foi necessária cirurgia em 6 doentes. Conseguiu--se apirexia em média após 6,4 (±6,4) dias. Ocorreram complicações em 21 doentes; 7 faleceram. A duração média do internamento foi de 27,5 (±16,3) dias e 38 doentes foram convocados para consulta pós-alta.

Estes dados são, em geral, concordantes com a literatura. A elevada percentagem de doentes do sexo masculino coincide com maior prevalência do alcoolismo e do carcinoma pulmonar nos homens. Aspectos pertinentes no sentido de melhorar o prognóstico e tempo de internamento poderão ser a brevidade no diagnóstico e o consenso no tratamento antibiótico.

Palavras-chave:
Abcesso pulmonar
pneumonia necrotizante
infecções pulmonares
Full text is only aviable in PDF
Bibliography/Bibliografia
[1.]
H.A. Cassiere, A.M. Fein.
Lung abscess: diagnosis and treatment.
Medscape General Medicine, 1 (1999),
[2.]
N.G. Mansharamani, H. Koziel.
Chronic lung sepsis: lung abscess, bronchiectasis and empyema.
Curr Opin Pulm Med, 9 (2003), pp. 181-185
[3.]
P.E. Marik.
Aspiration pneumonitis and aspiration pneumonia.
N Engl J Med, 344 (2001), pp. 665-671
[4.]
T. Franquet, A. Giménez, N. Rosón, et al.
Aspiration diseases: findings, pitfalls and differential diagnosis.
RG, 20 (2000), pp. 673-685
[5.]
J.G. Bartlett, S.L. Gorbach.
The triple threat of aspiration pneumonia.
Chest, 68 (1975), pp. 560-566
[6.]
J.L. Wang, K.Y. Chen, C.T. Fang, et al.
Changing bacteriology of adult community-acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes.
Clin Infect Dis, 40 (2005), pp. 915-922
[7.]
J.G. Bartlet.
The role of anaerobic bacteria in lung abscess.
Clin Infect Dis, 40 (2005), pp. 923-925
[8.]
J.L. Hang, J.D. Hardy.
Lung abscess revisited. A survey of 184 cases.
Ann Surg, 197 (1983), pp. 755-761
[9.]
J.S. Moreira, J.J.P. Camargo, J.C. Felicetti, et al.
Lung abscess: analysis of 252 consecutive cases diagnosed between 1968 and 2004.
J Bras Pneumol, 32 (2006), pp. 136-143
[10.]
A. Sosenko, J. Glassroth.
Fiberoptic bronchoscopy in the evaluation of lung abscesses.
Chest, 87 (1985), pp. 489-494
[11.]
W.C. Winn Jr., R.L. Myerowitz.
The pathology of Legionella pneumonias. A review of 74 cases and the literature.
Hum Pathol, 12 (1981), pp. 401-422
[12.]
B. Hirshberg, M. Sklair-Levi, R. Nir-Paz, et al.
Factors predicting mortality of patients with lung abscess.
Chest, 115 (1999), pp. 746-750

Nota: Trabalho apresentado como comunicação oral no 13.° Congresso Nacional de Medicina Interna – 6th European Federation of Internal Medicine Congress, Lisboa, Maio de 2007 / Note: This work was presented as an oral communication at the 13th National Congress of Internal Medicine – 6th European Federation of Internal Medicine Congress, Lisbon, May 2007.

Copyright © 2009. Sociedade Portuguesa de Pneumologia
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?